Proper closure and blinking of the eyelids is essential for normal ocular health and functionality. This is because closing the eyes covers the eye with a thin layer of tear fluid, promoting a moist environment necessary for the cells of the exterior part of the eye. Additionally, the tears flush out foreign bodies. With incomplete eyelid closure, the eye is constantly exposed to the drying effects of outside air, as well as to dust particles and debris.
Some individuals suffer from lagopthalmos, which is the inability to close, or poor closure, of the upper eyelid. If eyelid closure is impaired, the eye can suffer abrasions and infections. The condition also can lead to corneal drying and ulceration. Thus, a critical consideration in the treatment of lagophthalmos is the protection of the eye.
Lagopthalmos can result from paralysis of the facial nerve which controls eyelid function. This paralysis can be permanent or transitory. It can also be an indirect consequence of the surgical removal of certain types of tumors in close proximity to the facial nerve control eyelid function, such as eyelid closure. Lagopthalmos can also result from other cosmetic procedures such as when a cosmetic/plastic surgeon performs an upper blepharoplasty, which is an operation performed to remove excessive skin overlying the upper eyelid that often occurs with aging. If excessive skin is removed, lagopthalmos can result. Nocturnal lagophthalmos also affects some people—a person diagnosed with nocturnal lagophthalmos is unable to close their eyelids completely when they sleep, leaving the eyes exposed to more dust and debris during the overnight hours.
Weighted eyelid implants have been used in the surgical treatment of lagophthalmos. For example, U.S. Pat. Nos. 7,108,718; 6,482,428 and 5,542,437 describe the use of weighted eyelid implants. When implanting the weight in the patient's eyelid, a surgeon makes an incision on the surface of the upper eyelid above the lashes. A small pocket is created in which the device is inserted, and the device is held in position inside this pocket with small sutures. Additional sutures are then used to reclose the incision. When the eyelids' levator muscle is relaxed, the upper eyelid is lowered by the force of gravity, substantially closing the eyelid.
Weighted eyelid implants are traditionally made of gold, making them an expensive therapy, particularly if the implants need to be replaced. In some instances the implanted weight is found to be too heavy or too light after it has been implanted within the eyelid, which can be a result of an improved or worsening of the patient's condition. Typically, in order to revise the procedure, an oculoplastic surgeon has to make an incision on the surface of the upper eyelid to remove the previously implanted weight from the suture attachment inside the eyelid, and then replace it with a new weight (of higher or lower weight) by suturing the new weight to the patient's eyelid. Additional sutures are then used to reclose the incision and the patient has to undergo the healing process again. Alternatively, a patient's ability to close their eyelid may improve, and thus require less weighted assistance to close their eyelid. Again the patient would have to undergo substantial trauma to the eyelid to remove the previously implanted weight, and replace it with an appropriate weight.